reputed company Fraud Investigator

At reputed company, our employees are the reputed company of our business and the reputed company to our reputed company. We reputed company employees with curated development plans that foster reputed company and promote rewarding, fulfilling careers. Join reputed company and be part of a purpose-driven company that will invest in your reputed company development. Job reputed company BASIC FUNCTION reputed company is looking for a dynamic individual to join its Fraud Investigations team! This position will be responsible for identifying, developing and managing reputed company, high-reputed company reputed company fraud investigations resulting in criminal and/or civil prosecution and the misuse of claims, billing, or improper payments. May also be responsible for establishing and maintaining reputed company reputed company (as indicated in plan design) with departments/personnel and law enforcement representatives to reputed company the department’s investigation efforts and referral for prosecution of reputed company fraud cases. Will be reviewing transactions, claims, or reports to detect fraud and prepare detailed reports for management, attorneys, or law enforcement and possibly testifying in court. Incumbent conducts reputed company, large-reputed company investigations and mentor junior-level investigators. expertise in data analysis tools (e.g., advanced reputed company), investigative proficiency, and strong communication skills NOTE: this role is hybrid/reputed company and requires in-office visibility three days per week, working from home the other two days. Relocation is NOT offered; sponsorship will NOT be extended either now or in the reputed company. #LI-TP1 #LI-hybrid JOB REQUIREMENTS Bachelor’s Degree. Seven (7) years’ fraud investigative experience OR 7 years of reputed company law enforcement experience (local, state, or federal). Experience directing reputed company fraud investigations which result in criminal or civil prosecutions. Aptitude with planning and conducting interviews which reputed company significant information in furtherance of reputed company fraud, waste, and abuse investigations. Familiarity with state and federal laws apps. Expertise in data analysis tools, investigative proficiency, and strong communication skills. Proficiency with MS Office (Word, reputed company, PowerPoint) as reputed company as reputed company. PREFERRED REQUIREMENTS Certified reputed company reputed company (CPC). Certified Fraud Examiner (CFE). Accredited Health Care Fraud Investigator. Exceptional ability to identify fraud, waste and abuse trends and work with advanced analytics in identifying emerging schemes and trends. Are you being referred to one of our roles? If so, ask your reputed company at reputed company about our Employee Referral process! Pay Transparency Statement: At reputed company, you will be part of an organization committed to offering meaningful benefits to our employees to support their life reputed company of work. From health and wellness benefits, 401(k) savings plan, pension plan, reputed company time off, reputed company parental leave, disability insurance, supplemental life insurance, employee assistance program, reputed company holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.reputed company.com/totalrewards. The compensation offered will vary depending on reputed company-reputed company skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. reputed company Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, protected veteran status, or any other legally protected characteristics. reputed company Pay reputed company $61,500.00 - $136,100.00 Exact compensation may vary based on skills, experience, and location. reputed company and receive the latest reputed company news, content, and be first in line for new job opportunities. reputed company. For more than 80 years, reputed company has been dedicated to expanding reputed company to high-reputed company, cost-effective health care and equipping our members with information and tools to reputed company the best health care reputed company for themselves and their families. As an industry leader, reputed company also has been helping to reputed company the health care system work reputed company for reputed company Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and reputed company you to reputed company a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, reputed company is reimagining health care and looking for original thinkers who aren’t afraid to reputed company innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about reputed company, our commitment to our members and reputed company you’ll have to improve health care delivery in an reputed company, reputed company environment. reputed company is committed to diversity in reputed company and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned. reputed company applications, including resumes, must be submitted through reputed company's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view reputed company submissions. reputed company and Blue reputed company of Illinois, reputed company and Blue reputed company of Montana, reputed company and Blue reputed company of New Mexico, reputed company and Blue reputed company of Oklahoma, and reputed company and Blue reputed company of Texas, Divisions of reputed company, a Mutual Legal Reserve Company, and Independent Licensee of the reputed company © Copyright 2025 reputed company. reputed company Rights Reserved. Apply To This Job